News (Updated July 16, 2006)
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Fri Jul 14, 2006 05:30 PM ET
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LILONGWE (Reuters) - Former U.S. President Bill Clinton on Friday urged African governments to encourage people to take voluntary AIDS tests, saying it was the only way that newly available drugs would have an impact on the epidemic.
"People living with HIV and AIDS can live a normal life if they go for testing to know their status. We'll bring the medicine and it does not matter at what cost but how many lives will be saved and changed," Clinton said.
AIDS kills 10 people in Malawi per hour, and at least one million of the small southern African country's total population of 12 million is infected, according to official statistics.
Clinton's foundation has been working to make cheaper anti-retroviral (ARV) AIDS drugs available in Africa, and he has in the past voiced support for mandatory HIV/AIDS tests in countries with high infection rates.
Mandatory testing remains controversial, with some activists fearing it could expose infected people to stigma particularly in countries where treatment is not readily available.
Clinton's visit to Malawi was to unveil new projects undertaken by the Clinton-Hunter Foundation Development Initiative, which aims to address poverty and the HIV/AIDS pandemic.
Clinton commended Malawi -- one of Africa's poorest and least developed nations -- for its anti-poverty agenda.
"You have set the right priorities. We have come here to build a partnership with poor people to help them help themselves. I promise you that together we'll keep the score," he said.
The CHDI has set aside an initial $100 million for Malawi and Rwanda.
The first projects under the Clinton-Hunter initiative will invest in education, health, infrastructure, agriculture, and enterpreneurial support.
"This is a private sector initiative by two individuals who are touched by poverty in Malawi and are committed to assist in alleviating in," Malawi President Bingu wa Mutharika said at Friday's ceremony.
Tom Hunter, a Scottish philanthropist and retail magnate has staked $100 million on the initiative. He is ranked by Forbes Magazine as the 548th richest person in the world.
Fri Jul 14, 2006 01:12 PM ET
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NEW DELHI (Reuters) - Jitendra Shekhawat has never been to a condom party before, but he has a great idea for an ice-breaker -- he blows up a condom until it explodes.
The party, in a wooden shack festooned with condom balloons in the middle of a sprawling truck parking lot, is one of many approaches increasingly used by Indian businesses as they try to work out their role in a country that recently became the world's HIV capital.
Shekhawat and the party's 30 or so other guests are all long-haul truckers, decked in oily clothes and with hair still untidy from a night's sleep in their vehicle's cabin.
The hosts are workers from an HIV-prevention charity, hoping to impart as much information about the deadly virus as possible before the truckers set off on their next job, where they will end up thousands of miles from their wives but only 100 rupees (1.17 pounds) away from sex with a prostitute.
"It has to be fun or the message doesn't get across," says Sumant Kumar, a coordinator for the charity, Modicare Foundation, as the truckers send freshly inflated condom zeppelins wafting behind his head.
But attitudes can be hard to change, especially among many of India's countless millions of migrant workers who spend months away from home, and for many of whom hiring a prostitute is not unusual once a game of cards turns dull.
"I am quite faithful to my wife," one 23-year-old trucker says. "But sometimes if I find a good girl when I am out on long tours in south India, I'll sleep with her. It passes the time."
OSTRICH MENTALITY
India recently overtook South Africa as the country with to the most people living with HIV -- an estimated 5.7 million, according to the United Nations.
And according to the National AIDS Control Organization, most of these people are between 15 and 35, in what should be the most productive years of their lives.
Employers know all this.
"Everyone's been to these conferences where they reel off relevant costs to the industry," points out economist Indrani Gupta. But only a minority of companies is choosing to act.
Unlike many African countries, the prevalence of HIV is still relatively low in India -- less than 1 percent of the billion-plus people, if estimates are correct. Some say this has lulled the many businesses into a false sense of security.
"There's a lot of ostrich mentality. People are thinking, 'There's no problem here so why do we need to do something?"' said Shefali Chaturvedi, director of the Indian Business Trust for HIV and AIDS.
The trust was launched in 2001 by the Confederation of Indian Industry, an association of about 5,000 public and private sector businesses, to encourage industry to do more.
"Business has to play a leadership role," said Chaturvedi. "They must look at it as an issue which, given the way the situation is going, it is likely to affect their own productivity."
The trust is asking companies to adopt its HIV policy, an undertaking to educate employees and not to discriminate against those with the virus.
So far, about 500 have signed up, including Hero Honda Motors and Tata Steel Ltd.
NICE OR NECESSARY?
No one is sure to what extent a company should spend money on HIV-prevention programs out of some sense of corporate decency, and to what extent a smaller outlay now might stave off larger costs from HIV-related illnesses in employees.
R.N. Mukhija, a director at Larsen & Toubro Ltd., one of India's largest engineering firms, says it is a mixture of the two. The company, which employs about 20,000 people, has run an ever-expanding HIV-prevention strategy since the mid-1980s. The company is aware of about a dozen staff infected.
"If we had not spread awareness it would have been much more," he says.
He describes the cost of the program as insignificant.
The cost of the Modicare Foundation's program would not make a big dent in a typical large company's training budget. In a recent program, Modicare's trainers visited Prakash Industries Ltd. five days a month over seven months, teaching 1,300 of its employees about HIV and AIDS.
For this, Prakash paid about 80,000 rupees.
The International Labour Organization estimates paying for treatment for just one HIV-infected employee, including antiretroviral drugs, would cost 20,000 rupees a year, plus costs from absenteeism and treatment for the opportunistic infections those with HIV are prone to catch.
It says the cost of late intervention is 3.5 to 7.5 times the cost of early prevention.
But when many companies rely heavily on subcontracted migrant workers, it can be difficult to run an effective program.
"A company can have a superb policy for its 300 or 400 core staff, but if it doesn't trickle down to their informal workforce then it's not reaching the people who really need it," says Denis Broun, the India coordinator for the UN's HIV-prevention agency.
Worse still, there is little to prevent a business putting bottom lines ahead of an individual worker's welfare.
"There is no dearth of manpower in India," says Broun. "So, if one was to look at things cynically, if you lose an employee and advertise the position you're going to have a hundred applicants."
Sun Jul 16, 2006 09:12 AM ET
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ST PETERSBURG, Russia (Reuters) - The Group of Eight industrial nations renewed their pledge to fight the AIDS virus on Sunday but offered no detailed plan on how they would fund the ambitious targets they have set.
Campaigners say rich countries must increase AIDS funding urgently or they will miss their own target, set at the G8 summit in Gleaneagles, Scotland, last year, of providing AIDS treatment to 4 million Africans by 2010.
"Basically, we have slightly stronger words than Gleneagles but (are) still seriously short on the cash," said Max Lawson, a policy adviser with the Oxfam aid agency.
A final communique on infectious diseases approved by the G8 leaders said they would work to secure funds for the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2006/7 -- a more precise timetable than before.
The communique also expanded the G8's priorities in fighting AIDS to include prevention, instead of focusing just on treating people already infected. Campaigners welcomed the widened scope.
Donors say G8 countries, taken together, are spending half of what is needed to meet the 2010 target.
The Global Fund, which relies primarily on government contributions, says it urgently needs nearly $1 billion just to meet its existing commitments.
"NO CLEAR SIGNAL"
"What we were hoping for here was a concrete, time-bound plan, costed and with clear financial commitments," said Oliver Buston, European director for DATA, a lobby group led by Irish rock star Bono.
"We haven't got it. We have got some firming up of the commitment in some ways but we haven't got a clear signal the global fund is going to be scaled up to meet the challenge."
The G8 communique said combating AIDS "will continue to be one of our top priorities. We remain committed to halting and reversing the spread of HIV/AIDS."
Another lobby group said it was disappointed the statement contained no plan to reverse the drain of healthcare workers from African countries to the developed world.
"There is aid going to clinics that do not have any nurses," said Kate Krauss of Physicians for Human Rights.
G8 leaders said in the communique they recognized the shortage of healthcare workers in poor countries and would support efforts to tackle it.
But Krauss said: "There is still no investment and no specific plan to address this shortfall in health workers from G8 countries."
Russia, host for this year's summit, made fighting infectious diseases one of the key themes.
The communique also said G8 leaders were determined to achieve progress on fighting tuberculosis and malaria, and on responding effectively to outbreaks of bird flu and preparing for a possible human influenza pandemic.
Scientists say a pandemic might occur if the bird flu virus mutates so it can be transmitted from human to human.
by Frank ZellerFri Jul 14, 8:18 AM ET
The
social stigma associated with HIV/AIDS, along with a lack of data about the
spread of the disease, raise the risk of a wider epidemic in Vietnam, a US
think tank has warned.
Communist Vietnam commonly locks up rather than treats HIV-positive intravenous drug users and commercial sex workers, while a third high-risk group, men who have sex with men, are a taboo subject, the CSIS study found.
Some of the detention centres for tens of thousands of heroin addicts and prostitutes had served as "incubators" of HIV/AIDS, said Phillip Nieburg, a chief author of the Center for Strategic and International Studies report.
"People living with HIV/AIDS are highly stigmatised in Vietnam, regardless of how they became infected, leading to reluctance to seek prevention, testing and treatment services," said the report.
The Washington-based think-tank in January conducted a study tour of Vietnam led by former US health secretary Tommy Thompson, and it officially presented the report in Hanoi on Friday.
It praised Vietnam's health care system and its efforts to fight bird flu and SARS and said its centralised political system, which extends from Hanoi to nationwide youth and women's groups, could do much to tackle HIV/AIDS.
UN, US and other donor support had risen tenfold in the past five years to over 50 million dollars annually, and future political leaders were now being taught about the problem in the elite Ho Chi Minh Political Academy, it said.
UNAIDS Vietnam chief Nancy Fee also praised a law due to take effect in coming months that will legalise anti-HIV measures such as syringe exchanges and methadone programmes and strengthen the confidentiality of HIV tests.
But the CSIS report cautioned that the true extent of the disease remained unknown, as crucial data such as the number of HIV-positive people and AIDS patients in hospitals and rehabilitation centres remained unavailable.
According to the best available estimates, Vietnam's epidemic is still concentrated in high-risk groups and is "of manageable proportions," with about 300,000 out of 83 million people believed to be carrying the virus, it said.
National HIV prevalence was below 0.5 percent, but the rate has risen to 1.2 percent in the southern metropolis of Ho Chi Minh City, 1.1 percent in the major port city of Haiphong and 0.7 percent in Hanoi.
In a worrying report earlier this week, Vietnam's Labour daily quoted health ministry officials as saying that the percentage of HIV infections among pregnant women had risen from 0.02 percent in 1994 to 0.37 percent in 2005.
CSIS also said more than half of Vietnam's reported HIV carriers were intravenous drug users (IDUs), mostly heroin addicts.
"Like Thailand and China, HIV prevalence among IDUs began rising sharply in Vietnam in the late 1990s and now exceeds 70 percent in some cases," it said.
Vietnam -- which classifies illegal drug use, prostitution and general crime as "the three social evils" -- incarcerates 40,000 to 80,000 drug users and prostitutes in some 80 rehabilitation centres, it said.
Of Vietnam's incarcerated heroin users, 50 to 70 percent were believed to be HIV-positive, often without knowing it, said the report, warning that over 15,000 inmates were due to be released this year.
"How they will be cared for is currently unknown," said the report. "A high proportion (30 percent or more) of these persons live with HIV, and many are likely to have already progressed to AIDS."
To stem the spread of the disease, Vietnam needs to "resolve the clash between public health and public security objectives," said the report.
"Reducing the tension between these two national policy interests is the single greatest challenge before Vietnam in its evolving efforts to control HIV/AIDS."